Follow-up on Fluorosis/Tooth Decay

FAN Science Watch | Sept. 28, 2004 | By Michael Connett

In response to yesterday’s bulletin, Dr. Robert Carton – the former president of EPA’s Headquarters Union in Washington D.C. – forwarded me an internal agency memo that was written in the midst of EPA’s deliberations on their Maximum Contaminant Level (MCL) for fluoride. The memo, written in July 1984 by the then Director of EPA’s Office of Drinking Water, Victor Kimm, stated:

“It is difficult to conclude a priori that teeth which spontaneously pit are stronger teeth. Further data suggest that the effects of fluorosis are not merely discoloration and pitting, but fracturing, caries and tooth loss as well…it is difficult…to conclude that such effects are not adverse.” (Kim, V.; Memorandum to William Ruckelshaus, 7/26/84.)

Of course, the MCL that EPA ended up supporting (4 ppm) is a level where moderate to severe dental fluorosis is known to occur in about 40% of children. Even EPA readily conceded at the time that their “safe” level of fluoride would not protect against children developing severe dental fluorosis.

Perhaps most telling in the EPA MCL saga, is the fact that the very same EPA scientist who actually wrote the standard for the MCL, also wrote the following satirical press release that was circulated among staff scientists as the new MCL was announced to the public:

“The Office of Drinking Water in conjunction with OMB proudly presents their new and improved Fluoride Regulation or ‘How we stopped worrying and learned to love funky teeth.’ Up to now EPA, under the Safe Drinking Water Act, has regulated fluoride in order to prevent children from having teeth which looked like they had been chewing brown shoe polish and rocks. The old standard which was based upon the consumer’s average shoe size and the phase of the moon generally kept fluoride levels below 2.3 mg/l. EPA in response to new studies which only confirmed the old studies, and some flat out political pressure, has decided to raise the standard to 4 mg/l. This increase will allow 40% of all children to have teeth gross enough to gag a maggot. EPA selected this level based upon a cost effectiveness study which showed that it is cheaper for people to keep their mouths shut then to remove the fluoride.”

In light of the obvious politics/corruption that was at play in the EPA standard, some have suggested that there’s not a great need to “exercise ourselves with new references”, that it’s all already there in black and white. This may be true, but I still think it’s extremely important that we as a movement continue to keep ourselves abreast of the latest and best research. It only makes our case stronger, and further separates us from the proponents. I recently had an experience which brought this home to me in a very big and positive way. If we are to make inroads with individuals/organizations that are not familiar with this issue, we need to be on top of every detail, every study – to the extent possible. Also, this is a “science-watch” bulletin after all:) The goal here is to monitor PubMed and bring light to studies that people may find of interest, and to put the new studies in the context of old. On this note, I am very grateful to Dr. Carton for calling attention to the memo above, as it’s certainly very important and relevant to the discussion at hand.